Wada Yohnosuke, Ohtsuka Hideo, Adachi Kensuke
Department of Surgery, Tokyo Metropolitan Tama Medical Center, 2-8-29, Musashidai, Fuchu, Tokyo, 183-8524, Japan.
J Gastrointest Surg. 2015 Oct;19(10):1925-6. doi: 10.1007/s11605-015-2881-5. Epub 2015 Jul 11.
In this report, we highlighted the clinical manifestations of obturator hernia and focused on laparoscopic views. Given its rarity and vague symptoms, the early diagnosis of obturator hernia presents a challenge. Although delays in diagnosis cause high rates of morbidity and mortality, CT with multi-planar reformations provides an excellent means of preoperative diagnosis. Despite current progress of laparoscopic surgery, its indication is believed to be limited only in elective obturator hernia repairs because of technical difficulties associated with bowel strangulation followed by a resection anastomosis. However, in selected cases, laparoscopic techniques can provide a minimally invasive option for obturator hernia repairs. These laparoscopic views, together with CT imaging, allow a better understanding of spatial anatomy and abnormality surrounding an obturator hernia.
在本报告中,我们重点介绍了闭孔疝的临床表现,并着重阐述了腹腔镜下的观察情况。鉴于其罕见性和症状不明确,闭孔疝的早期诊断颇具挑战。尽管诊断延迟会导致高发病率和死亡率,但多平面重建CT是术前诊断的极佳手段。尽管目前腹腔镜手术取得了进展,但由于与肠绞窄及随后的切除吻合相关的技术难题,其应用指征被认为仅局限于择期闭孔疝修补术。然而,在某些特定病例中,腹腔镜技术可为闭孔疝修补提供微创选择。这些腹腔镜下的观察结果,结合CT成像,有助于更好地了解闭孔疝周围的空间解剖结构及异常情况。